Risk factors for isolation of multi-drug resistant organisms in coronavirus disease 2019 pneumonia: A multicenter study
- Abstract
- Objectives: Superimposed multi-drug resistant organisms (MDROs) co-infection can be associated with worse outcomes in patients with severe coronavirus disease 2019 (COVID-19), even if these patients were managed with strict airborne and contact precautions. Identifying risk factors for isolation of MDROs is criti-cal to COVID-19 treatment. Methods: All eligible adult patients with confirmed COVID-19 pneumonia from 10 hospitals in the Republic of Korea between February 2020 and May 2020 were retrospectively enrolled. Using this cohort, epidemiol-ogy and risk factors for isolation of MDROs were evaluated. Results: Of 152 patients, 47 with microbial culture results were included. Twenty isolates of MDROs from 13 (28%) patients were cultured. Stenotrophomonas maltophilia (5 isolates) was the most common MDRO, fol-lowed by methicillin-resistant staphylococcus aureus (4 isolates). MDROs were mostly isolated from sputum samples (80%, 16/20). The median time from hospitalization to MDRO isolation was 28 days (interquartile range, 18-38 days). In-hospital mortality was higher in patients with MDRO isolation (62% vs 15%; P = .001). Use of systemic corticosteroids after diagnosis of COVID-19 (adjusted odds ratio [aOR]: 15.07; 95% confidence interval [CI]: 2.34-97.01; P =.004) and long-term care facility (LTCF) stay before diagnosis of COVID-19 (aOR: 6.09; 95% CI: 1.02-36.49; P = .048) were associated with MDRO isolation. Conclusions: MDROs were isolated from 28% of COVID-19 pneumonia patients with culture data and 8.6% of the entire cohort. Previous LTCF stay and adjunctive corticosteroid use were risk factors for the isolation of MDROs. Strict infection prevention strategies may be needed in these COVID-19 patients with risk factors. (c) 2021 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
- All Author(s)
- H. J. Son
; T. Kim
; E. Lee
; S. Y. Park
; S. Yu
; H. L. Hong
; M. C. Kim
; S. I. Hong
; S. Bae
; M. J. Kim
; S. H. Kim
; J. H. Yun
; K. M. Jo
; Y. M. Lee
; S. Lee
; J. W. Park
; M. H. Jeon
; T. H. Kim
; E. J. Choo
- Intsitutional Author(s)
- 유시내; 박정완; 전민혁
- Issued Date
- 2021
- Type
- Article
- Keyword
- COVID-19; SARS-CoV-2; Antimicrobial resistance; Long-term care facility; Corticosteroids
- Publisher
- Association for Practitioners in Infection Control
- ISSN
- 0196-6653
- Citation Title
- American Journal of Infection Control
- Citation Volume
- 49
- Citation Number
- 10
- Citation Start Page
- 1256
- Citation End Page
- 1261
- Language(ISO)
- eng
- DOI
- 10.1016/j.ajic.2021.06.005
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/1335
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